Antiplatelet Agent
- prevention of arterial thrombi
Clopidogrel & Ticlopidine
- inhibit ADP-dependent aggregation of platelet
Glycoprotein GP IIb/IIIa Receptor Antagonist
- inhibit diverse agonist,ex: ADP & TXA2
Aspirin
- inhibit cyclo-oxygenase
- altering balance between TXA2 (which promote platelet aggregation)& PGI2 (which inhibits platelet aggregation)
Anticoagulant
Injectable
Oral
2. Low Molecular Weight Heparin (LMWH)
3. Fendaparinux
- Factor xa inhibitor
- use: various thrombosis associated with orthopedic surgery
1.Unfractionated Heparin (UFH)
4.Argathroban & Lepirudine
- direct thrombin inhibitors
- use in pt with heparin induced throbocytopenia & those going under per-cutaneous coronary intervention
Warfarin
- Vitamin K antagonist
- Delayed onset
- Monitoring parameter: PT/INR
- Adverse effects: haemorrphage, purple toe syndrome
- use:
-- prophylaxis & treatment of DVT,Pulmonary embolism
-- prevention of thrombus formation after val replacement
-- prevention of treatment of atrial fibrillation with embolization
-- part of treatment of myocardial infarction
Newer oral anticoagulant
- replace warfarin in VTE
& atril fibrillation
Rivaroxaban, apixaban, betrixaban
- Xa inhibitor
Dabigatran
- direct thrombin inhibitors
Thrombolytic
/Fibrinolytic
1st generation
2nd & 3rd Generation
-tissue-type plasminogen activator=>produce a fibrin-selective activation of plasminogen
-Ex: Alteplase, Reteplase, Tenecteplase,Anistreplase
Streptokinase
- AR: hemorrhage, pyrexia, anaphylactic reaction
Urokinase
- activate both circulating and fibrinogen bound plasminogen